The present invention relates to removal of an implanted lead extending between distal and proximal ends from a body and, more particularly, to a technique which facilitates the complete removal of the lead from the body.
Lead extraction is required when an infection occurs and at times when products are upgraded or replaced. Current lead extraction techniques cut the connector from the lead, then mechanically lock into the lead conductor coil near the lead distal electrode. During lead extraction the distal end of the coil is deformed and the lead is no longer functional. There is a potential for lead fracture, resulting in incomplete extraction, and possibly requiring additional surgery to complete the procedure.
Typical of the known prior art are U.S. Pat. Nos. 5,013,310 and 5,011,482, both to Goode et al. which utilize a stylet wire which is inserted into the longitudinal passageway of an implanted lead, then secured at its distal end to the distal end of the implanted lead. Thereafter, the stylet wire is withdrawn and takes with it the implanted lead. U.S. Pat. No. 4,957,118 represents another example of the prior art in which an electrode lead is provided with a tine assembly having tines on an electrode tip which can be moved back and forth between a retracted position and an extended position. A threaded rod is rotatably mounted within the elongated body of the lead for moving the conductive electrode tip relative to the non-conductive tubular body. In a number of instances, as in U.S. Pat. No. 4,924,881 to Brewer, an implantable endocardial lead includes a retractable fixation device such as a sharpened helix. A threaded stylet passes through a lumen from a proximal end to a distal end of the lead where the stylet is screwed into a piston supporting the helix. When the helix is in an exposed position, torque can be transmitted by the stylet from the proximal end of the lead through the distal end to the piston and thence to the helix to screw the helix into the endocardial tissue. Similar constructions are disclosed in U.S. Pat. Nos. 5,129,404 and 5,593,433 to Spehr et al. and in U.S. Pat. No. 5,259,395 to Li.
U.S. Pat. No. 5,662,698 to Altman et al. discloses an implantable lead system that uses a locking stylet to adjust the insulation around the lead during implantation.
U.S. Pat. No. 5,769,858 to Pearson et al. discloses an implantable lead system that includes a locking stylet for extracting the lead wherein the locking lead interacts with a kinked distal tip to lock into the distal tip.
U.S. Pat. No. 5,800,497 to Bakels et al. discloses an implantable lead system that uses a magnetically interactive material that hardens in the presence of a magnetic field to lock a stylet into the lead during explant.
U.S. Pat. No. 5,807,399 to Laske et al. discloses a lead removal system that includes pulling the electrode within the lead and then collapsing the lead to remove it from the body.
It was in light of the foregoing that the present invention was conceived and has now been reduced to practice.
The present invention discloses a technique for removing an implanted lead from a body. This technique includes the operation of releasably attaching an elongated stylet to the distal end of the implanted lead, specifically, the electrode at the distal end of the lead. This results in a reasonably unified stylet and implanted lead structure whereby withdrawal of the stylet and of the implanted lead as a unit facilitates the complete removal of the implanted lead from the body. A threaded tip end of the stylet is used for threaded engagement with a tapped bore in the electrode. The threaded tip end of the stylet becomes locked to the electrode by rotating in one direction the threaded portion into the threaded bore and the stylet is removable by counter-rotating the threaded tip end of the stylet relative to the electrode.
This new lead extraction system mechanically locks the stylet into the lead distal tip to provide force and control at the location where the lead adheres to the myocardium. This invention will improve lead extraction in the form of fewer lead fractures, leaving no lead fragments in the heart as compared to existing lead extraction systems. If a decision is made to abort the lead removal, the threaded stylet can be unscrewed, leaving the lead unchanged. Also, inserting this extraction stylet would not require that the lead connector be cut off, which could also improve the situation if a lead extraction is aborted.
A primary feature, then, of the present invention is the provision of a technique for removal from a body of an implanted lead extending between distal and proximal ends.
Another feature of the present invention is the provision of such a technique, which facilitates the complete removal of the lead from the body.
Yet another feature of the present invention is the provision of such a technique according to which lead extraction is achieved by mechanically engaging the distal tip electrode and thereby eliminating the possibility of lead fracture and partial lead extraction.
Still a further feature of the present invention is the provision of such a technique according to which lead extraction can he aborted, leaving the lead unchanged.
Yet a further feature of the present invention is the provision of such a technique according to which cutting of the lead at the connector is not required as is currently required by known methods.
Still another feature of the present invention is the provision of such a technique according to which a known implant method and stylet will function properly with leads incorporating the novel concept of the invention.
Yet another feature of the present invention is the provision of such a technique according to which the electrode is actively fixed to body tissue.
Other and further features, advantages, and benefits of the invention will become apparent in the following description taken in conjunction with the following drawings. It is to be understood that the foregoing general description and the following detailed description are exemplary and explanatory but are not to be restrictive of the invention. The accompanying drawings which are incorporated in and constitute a part of this invention, illustrate one of the embodiments of the invention, and together with the description, serve to explain the principles of the invention in general terms. Like numerals refer to like parts throughout the disclosure.